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肾性甲状旁腺功能亢进症次全甲状旁腺切除术的手术结果

Surgical Outcomes of Subtotal Parathyroidectomy for Renal Hyperparathyroidism.

作者信息

Kim Min Song, Kim Gheun-Ho, Lee Chang Hwa, Park Joon-Sung, Lee Ji Young, Tae Kyung

机构信息

Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

出版信息

Clin Exp Otorhinolaryngol. 2020 May;13(2):173-178. doi: 10.21053/ceo.2019.01340. Epub 2020 Feb 21.

DOI:10.21053/ceo.2019.01340
PMID:32075361
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7248609/
Abstract

OBJECTIVES

The aim of this study was to evaluate the effectiveness of subtotal parathyroidectomy for patients with renal hyperparathyroidism.

METHODS

We studied 25 patients with renal hyperparathyroidism who underwent subtotal parathyroidectomy from October 2002 to October 2017. We analyzed serum intact parathyroid hormone (iPTH), calcium, and inorganic phosphorus levels before and at multiple time points following surgery, and evaluated the surgical outcomes and complications.

RESULTS

Of the 25 patients, 13 (52%) were male and 12 (48%) were female, and the mean age was 53.4±9.3 years. The mean duration of dialysis before parathyroidectomy was 156.8±79.5 months. Mean preoperative serum iPTH and calcium levels were 1,199.0±571.3 pg/mL and 10.5±1.0 mg/dL, respectively. At 6 months postoperatively, the mean iPTH and calcium levels decreased to 49.2±47.6 pg/mL (P<0.01) and 8.0±1.0 mg/dL (P<0.01), respectively. Recurrent hyperparathyroidism occurred in two patients: one subsequently underwent kidney transplantation and the other continued hemodialysis and maintained normal calcium levels. One patient developed postoperative permanent hypoparathyroidism.

CONCLUSION

Subtotal parathyroidectomy is a safe and effective surgical treatment for renal hyperparathyroidism.

摘要

目的

本研究旨在评估甲状旁腺次全切除术治疗肾性甲状旁腺功能亢进患者的有效性。

方法

我们研究了2002年10月至2017年10月期间接受甲状旁腺次全切除术的25例肾性甲状旁腺功能亢进患者。分析了手术前及术后多个时间点的血清完整甲状旁腺激素（iPTH）、钙和无机磷水平，并评估了手术结果和并发症。

结果

25例患者中，男性13例（52%），女性12例（48%），平均年龄为53.4±9.3岁。甲状旁腺切除术前的平均透析时间为156.8±79.5个月。术前血清iPTH和钙的平均水平分别为1199.0±571.3 pg/mL和10.5±1.0 mg/dL。术后6个月，iPTH和钙的平均水平分别降至49.2±47.6 pg/mL（P<0.01）和8.0±1.0 mg/dL（P<0.01）。两名患者出现复发性甲状旁腺功能亢进：一名随后接受了肾移植，另一名继续进行血液透析并维持正常钙水平。一名患者术后发生永久性甲状旁腺功能减退。

结论

甲状旁腺次全切除术是治疗肾性甲状旁腺功能亢进的一种安全有效的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9241/7248609/f6b5dae28680/ceo-2019-01340f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9241/7248609/093d968e782f/ceo-2019-01340f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9241/7248609/56e0fa0d66cf/ceo-2019-01340f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9241/7248609/f6b5dae28680/ceo-2019-01340f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9241/7248609/093d968e782f/ceo-2019-01340f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9241/7248609/56e0fa0d66cf/ceo-2019-01340f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9241/7248609/f6b5dae28680/ceo-2019-01340f3.jpg

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